| NPI | 1649366584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: OR MD16138) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: WA MD00041338) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-13 |