NPI | 1669461836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS8411) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R2G09) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL OS8411) | |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MO r2g09) | |
Enumeration Date | 2005-10-19 |
Last Update Date | 2023-11-16 |