| NPI | 1639143878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35057893) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2013-08-02 |