| NPI | 1285186510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: WI 65977) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WI 65977-20) |
| 207Q00000X Family Medicine (Licence: WI 65977-20) | |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2023-06-16 |