| NPI | 1104356880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS17995) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL OS17995) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-05-31 |