| NPI | 1396701652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NV 8764) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NV 8764) |
| 208D00000X General Practice (Licence: NV 8764) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2025-03-05 |