| NPI | 1427638774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 72611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 31755) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-01-10 |