| NPI | 1609868702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: GA 055857) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: LA 019083) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: GA 055857) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: LA 019083) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2023-12-14 |