| NPI | 1972597490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: AZ 2269) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: TX K4950) |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: SD 4328) | |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: IA 2191) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: AZ 2269) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: CO 29397) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NM A-884-89) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NV 836) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: WY 6289) | |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: AZ 2269) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-11-04 |