| NPI | 1578558136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX M2796) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX M2796) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX M2796) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-07-11 |