| NPI | 1033285200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 23784) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 23784) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-01-28 |