NPI | 1801871827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL OS7279) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL OS7279) |
208D00000X General Practice (Licence: FL OS7279) | |
Enumeration Date | 2005-12-13 |
Last Update Date | 2022-11-17 |