| NPI | 1902021728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: TX J0475) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |