| NPI | 1265445985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OR OR MD17346) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WA WA MD0039341) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ 9691) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-09 |