| NPI | 1255657110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA A120314) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A120314) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A120314) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2015-07-08 |