| NPI | 1538158100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017615) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS-8195) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL Os-8195) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: OH 34.017615) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL Os-8195) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 34.017615) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2025-02-06 |