| NPI | 1558787747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 28673) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 28673) |
| 208D00000X General Practice (Licence: NE 28673) | |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2025-02-26 |