| NPI | 1184680332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME79864) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME79864) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME79864) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME79864) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME79864) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME79864) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-12-17 |