| NPI | 1659412823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA MD00024073) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD00024073) |
| 208D00000X General Practice (Licence: WA MD00024073) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2021-10-05 |