| NPI | 1750492351 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD 60270231)  | 
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA MD 60270231)  | 
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2021-04-08 |