| NPI | 1497961098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: HI 11334) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ME 9405) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 88866) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-11-08 |