| NPI | 1225188709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 15346) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101244995) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NV 15346) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-08-12 |