| NPI | 1447230123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: WA MD00025457) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD00025457) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2014-05-19 |