| NPI | 1619933884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: LA LA14443R) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: LA LA14443R) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-11-11 |