| NPI | 1649620402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS019027) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: PA OS019027) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2025-08-27 |