| NPI | 1023421377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0101258724) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VA 0101258724) |
| 208D00000X General Practice (Licence: VA 0101258724) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2024-01-04 |