NPI | 1568504934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA GFE36772) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME 66415) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2007-07-08 |