| NPI | 1063518967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NM 97382) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA A41183) |
| 208000000X Pediatrics (Licence: NM 97382) | |
| 208000000X Pediatrics (Licence: CA A41183) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2021-03-18 |