| NPI | 1821300880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: VA 0101251622) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 000000) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2024-06-07 |