| NPI | 1740293596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TN 18527) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NC 28732) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2015-06-24 |