| NPI | 1922126960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: TX H8452) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TX H8452) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |