| NPI | 1215399407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA A155816) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A155816) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-01-29 |