| NPI | 1487712667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301050208) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 4301050208) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |