| NPI | 1952383523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 59675) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AZ 59675) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AZ 59675) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2022-03-02 |