NPI | 1043357452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X (Licence: MO 2003022490) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2003022490) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MO 2003022490) | |
Enumeration Date | 2007-02-01 |
Last Update Date | 2025-08-11 |