| NPI | 1053379677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C129122) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01056653A) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IN 01056653A) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-04-30 |