| NPI | 1972519064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA C54777) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 226206) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2026-08-11 |