| NPI | 1811976541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME0066597) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX K3332) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME66597) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX K3332) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2011-05-09 |