| NPI | 1740711134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA OP61182777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID MRO-1647) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: ID MRO-1647) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: UT 10964114-1204) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-10-13 |