| NPI | 1841494051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 5720620) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: WI 57206-20) |
| 1744R1102X Specialist, Research Study | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2022-05-19 |