| NPI | 1972766566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: WV 14898) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: WV 14898) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2011-06-14 |