| NPI | 1790176733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 2033) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: GA 76766) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2022-06-29 |