NPI | 1902913106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QX0100X Clinic/Center Occupational Medicine (Licence: OR MD18309) |
Additional Taxonomies | 261QX0100X Clinic/Center Occupational Medicine (Licence: WA MD00026280) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2007-07-08 |