| NPI | 1073556304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA A55341) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A55341) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2026-09-10 |