| NPI | 1952324402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: WA MD60222687) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: CA G48069) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-06-27 |