| NPI | 1083979801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 1144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 1144) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 1144) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2023-08-10 |