| NPI | 1508927021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VA 0101027148) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101027148) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-09-05 |