| NPI | 1699920066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NV PA1977) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1977) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2024-03-14 |