| NPI | 1669656054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: LA 13333R) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: LA 13333R) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: LA 13333R) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: LA 13333R) | |
| 208D00000X General Practice (Licence: LA 13333R) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2007-12-21 |