| NPI | 1952725327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NC 2023-03318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G80727) |
| 207Q00000X Family Medicine (Licence: WA MD60536390) | |
| 207Q00000X Family Medicine (Licence: NC 2023-03318) | |
| 207Q00000X Family Medicine (Licence: SC 90752) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD60536390) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G80727) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 90752) | |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2024-02-14 |