| NPI | 1891784013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101235185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101235185) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VA 0101235185) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2021-07-21 |