| NPI | 1326029760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: DC MD034602) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD034602) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2025-06-12 |