| NPI | 1891879284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL OS9172) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX K9779) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL OS9172) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX K9779) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX K9779) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-31 |