| NPI | 1225014988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: WA MD60079005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 41033) |
| 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: CA 890470) | |
| 207R00000X Internal Medicine (Licence: IL 125662) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2011-01-12 |