| NPI | 1316915168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WA MD00041802) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00041802) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: WA MD00041802) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2009-11-23 |