| NPI | 1437353489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: VA 0101239447) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101239447) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2022-07-21 |