| NPI | 1457930265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101276392) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101276392) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2023-09-27 |