| NPI | 1952530164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 53156) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 53156) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2020-08-19 |