| NPI | 1114276706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 68902) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MN 68902) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2021-10-26 |