| NPI | 1376830059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MS 23337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 23337) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2023-08-15 |