| NPI | 1003853862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: AR E7122) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AR E7122) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2019-11-13 |