| NPI | 1942498118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX BP1-0022279) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0022279) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2009-07-08 |