| NPI | 1669463204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CO DR-33790) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO DR 33790) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2012-07-19 |