| NPI | 1225265721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OK 12427) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX G2179) |
| 208600000X Surgery (Licence: OK 12427) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2015-01-07 |