| NPI | 1477871382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 35135393) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 036.141707) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301096588) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35.135393CTR) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2023-02-07 |