| NPI | 1306833801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R8881) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO R8881) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-07-08 |