| NPI | 1346418167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: GA 061858) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: FL ME104952) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2013-09-27 |