| NPI | 1598962136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD60811730) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MD 010124465) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-04-28 |