| NPI | 1811989676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: UT 182257-1205) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: UT 182257-1205) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2015-04-20 |