| NPI | 1770551590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: PA MD022245E) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: PA MD022245E) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2016-02-11 |