| NPI | 1144260787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WA 00039308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00039308) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-03-30 |