| NPI | 1639289168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: NH 10413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 10413) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NH 10413) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-01-30 |