| NPI | 1013141282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD60235454) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OR MD159763) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2021-01-06 |