| NPI | 1285131854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: ND 16404) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: ND 16404) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-10-23 |