| NPI | 1538548714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101021993) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 20140) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MI 5101021993) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2024-07-31 |