| NPI | 1609149681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: IN 02004069A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02004069A) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2023-08-31 |