NPI | 1457338220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: UT 6471343-1204) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 6471343-1204) |
Enumeration Date | 2005-12-22 |
Last Update Date | 2023-01-24 |