| NPI | 1851566087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083T0002X Preventive Medicine Medical Toxicology (Licence: OR 11993) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OR 11993) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |