| NPI | 1609847649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA C42466) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA C42466) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA C42466) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2010-03-08 |