| NPI | 1790753002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 83268) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: GA 055325) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2019-10-23 |