| NPI | 1679795173 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 4301044314) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |