| NPI | 1134653348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 160835) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA Md.md.61124604) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2021-07-09 |