| NPI | 1083723944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO R7420) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO R7420) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-03-07 |