| NPI | 1700416617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: UT 14238975-1205) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2025-09-03 |