| NPI | 1023703691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0102208821) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102208821) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2025-11-07 |