| NPI | 1013988377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: MD D0042825) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: MD D0042825) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MD D0042825) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2007-07-08 |