| NPI | 1689636532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SD 3939) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA 28886) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ND 16038) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA MD-28886) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 18932) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-12-10 |