NPI | 1063909703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA 61342596) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA OL61342596) |
Enumeration Date | 2018-04-18 |
Last Update Date | 2024-10-21 |