| NPI | 1770710196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX T1693) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101248040) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2023-06-13 |