| NPI | 1194103614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MD D0091783) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208497) |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2021-11-17 |