| NPI | 1194797175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: NC 28851) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NC 28851) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2007-07-08 |