| NPI | 1619186459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ 36235)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 36235)  | 
| Enumeration Date | 2007-05-21 | 
| Last Update Date | 2024-02-22 |