NPI | 1659900710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 73810) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN31278) |
Enumeration Date | 2020-04-02 |
Last Update Date | 2023-10-25 |