NPI | 1275911745 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101261995) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101261995) |
Enumeration Date | 2015-05-15 |
Last Update Date | 2025-04-29 |