| NPI | 1043329899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 024771) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA a90911) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: LA 024771) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA a90911) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |