| NPI | 1851460505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: CA G29051) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: WI 19080) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2013-05-07 |