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 |