| NPI | 1720341191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NC 2020-03013) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TN MD021929) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 36492) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2022-04-01 |