| NPI | 1043325780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 8412) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: AZ 8412) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-07-21 |