| NPI | 1083866784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 52118) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: RI DO00690) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2013-06-25 |