NPI | 1114276607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: IL 036155720) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-08-30 |
Last Update Date | 2021-12-29 |