| NPI | 1093788366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: KS 04-12967) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO 2001026590) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-08-24 |