| NPI | 1962473918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WA MD00017232) |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2011-10-07 |