| NPI | 1114272317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 1103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1103) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 1103) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-07-22 |