| NPI | 1972593309 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35-067499)  | 
| Enumeration Date | 2005-10-26 | 
| Last Update Date | 2008-01-11 |