| NPI | 1669595989 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA RN397773) | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA NPF10607) | 
| Enumeration Date | 2007-04-10 | 
| Last Update Date | 2007-07-08 |