| NPI | 1649268533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NV 18972) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NV 18972) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: UT 358526-1205) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2023-08-03 |