| NPI | 1851394399 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME37951)  | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX M4802)  | 
| Enumeration Date | 2005-05-28 | 
| Last Update Date | 2015-12-10 |