| NPI | 1447248489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: SD 1950) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NM 92-182) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2007-07-08 |