| NPI | 1275761132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MI 5101018104) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 5101018104) |
| 208D00000X General Practice (Licence: MI 5101018104) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2024-07-02 |