| NPI | 1578791786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: PA MD475515) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NY 259483) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: MA 279400) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: OH 35.146232) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-11-21 |