| NPI | 1215125117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 100863) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01063919A) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2023-01-18 |