| NPI | 1588227698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 80417) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MN 35226) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-09-02 |