| NPI | 1992064471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: NE 27575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10043699) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-02-10 |