| NPI | 1134269772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WI 71662) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A90548) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2019-10-02 |