NPI | 1508187014 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: DE C1-0009960) |
Additional Taxonomies | 208000000X Pediatrics (Licence: DE C1-0009960) |
Enumeration Date | 2010-06-18 |
Last Update Date | 2025-07-16 |