| NPI | 1316231285 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 828988) | 
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: SC 82988) | 
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0102203210) | |
| Enumeration Date | 2011-06-07 | 
| Last Update Date | 2020-09-24 |