| NPI | 1942568084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX Q2469) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q2469) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2017-03-16 |