| NPI | 1346335809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA A96710) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A96710) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01064569A) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-03-29 |