| NPI | 1578635033 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME57480) | 
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: FL ME57480) | 
| Enumeration Date | 2006-11-13 | 
| Last Update Date | 2025-04-28 |