| NPI | 1497976294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: LA MD.201313) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: LA MD.201313) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-11-02 |