| NPI | 1326014267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD00034961) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OR 12830) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MT 5108) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |