| NPI | 1023004652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2005029307) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MO 2005029307) |
| 207P00000X Emergency Medicine (Licence: MO 2005029307) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2024-03-05 |