| NPI | 1972584779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 50345) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA A93163) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2015-09-02 |