| NPI | 1366412488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: ME MD19264) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA G51177) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA G51177) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA G51177) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2013-02-07 |