| NPI | 1932123007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 34004691) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34004691) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: OH 34-004691) | |
| 2083T0002X Preventive Medicine, Medical Toxicology (Licence: OH 34-004691) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-01-20 |