| NPI | 1366408353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: WA MD00040014) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: WA MD00040014) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2024-06-10 |