NPI | 1023269107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101244262) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101244262) |
Enumeration Date | 2008-10-07 |
Last Update Date | 2022-06-09 |