| NPI | 1811258775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 22605-020) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME112210) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |