| NPI | 1992042899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35071846) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G63595) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME113863) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA G63595) | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2016-02-03 |