| NPI | 1841618956 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: UT 9857459) | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301108523) | 
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A145248) | |
| Enumeration Date | 2014-04-04 | 
| Last Update Date | 2022-02-11 |