| NPI | 1992043731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD00021123) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OR MD11433) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |