NPI | 1679562441 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VA 0101268314) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101268314) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101268314) | |
Enumeration Date | 2005-10-14 |
Last Update Date | 2019-12-30 |