| NPI | 1295795433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MA 80243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 80243) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2018-04-03 |