| NPI | 1669608386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 20A11509) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA 20A11509) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2019-09-26 |