| NPI | 1336137371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 65841) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: OK 4313) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2024-05-29 |