| NPI | 1053387746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME0032843) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME 32843) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME 32843) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME 32843) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-11-01 |