| NPI | 1598260549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS17931) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS17931) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL OS17931) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-08-27 |