| NPI | 1063614139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G83623) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KS 04-30732) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2023-06-13 |