| NPI | 1982640926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0101230692) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35085405) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-02-18 |