| NPI | 1265460406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: WA MD61439872) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OR MD24481) |
| 207R00000X Internal Medicine (Licence: WA MD61439872) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-07-03 |