| NPI | 1144458092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 036.136396) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301104444) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2017-01-26 |