| NPI | 1497949580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NC 2015-00651) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MB07363700) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: GA 59673) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2015-09-28 |