| NPI | 1730677881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 31165) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OK 16402) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |