| NPI | 1114078912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: FL OS9975) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: FL OS044074) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: FL OS044074) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2023-04-06 |