| NPI | 1093769929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD23040) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OR MD23040) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2009-11-30 |