| NPI | 1609914431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: GA 043122) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: GA 43122) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2009-10-02 |