| NPI | 1205807377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C2-0005268) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: DE C2-0005268) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-05-23 |