| NPI | 1114953171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0102201421) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IL 036-072541) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL OS 4979) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2007-07-08 |