| NPI | 1235164807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CT 028310) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CT 028310) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-03-23 |