| NPI | 1255459558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-9075) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ID M-9075) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: ID M-9075) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-08-11 |