| NPI | 1093769648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA DO.14881R) |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: MS 14984) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-03-05 |