| NPI | 1952377178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AR E-2031) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AR E-2031) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2013-12-02 |