NPI | 1588770051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 42291) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: WI 42291-20) |
Enumeration Date | 2006-08-21 |
Last Update Date | 2022-07-11 |