| NPI | 1710367974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NV 25520) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 25520) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2024-08-08 |