NPI | 1124101969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IN 01055793A) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01055793A) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2007-07-08 |