| NPI | 1366451825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00011985) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD00011985) |
| 2083T0002X Preventive Medicine, Medical Toxicology (Licence: WA MD00011985) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA MD00011985) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WA MD00011985) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2012-03-22 |