| NPI | 1538656921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: ND 20073) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MN 69407) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.246410) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35.140521) | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2024-01-22 |