| NPI | 1659784726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MO 2021027634) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MO 2021027634) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2024-06-18 |