| NPI | 1124081971 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NM 95-230) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NM 95-230) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2007-07-08 |