| 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 |