| NPI | 1255339826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: CA G87090) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G87090) |
| 207P00000X Emergency Medicine (Licence: FL ME70844) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2018-12-13 |