| NPI | 1023498284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.148280.MIL) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME129540) |
| 208600000X Surgery (Licence: FL ME129540) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2024-10-29 |