| NPI | 1942290812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.23448) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AL 23448) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2016-01-04 |