NPI | 1801875612 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9583) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX Q9583) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01040212A) | |
Enumeration Date | 2006-01-10 |
Last Update Date | 2022-12-12 |