NPI | 1972714483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO 18782) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60011986) |
207P00000X Emergency Medicine (Licence: MA 238441) | |
Enumeration Date | 2007-05-25 |
Last Update Date | 2009-01-13 |