| NPI | 1346212271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9701020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 01020) |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: NC 9701020) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NC 9701020) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2010-07-13 |