| NPI | 1306868773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MD D33353) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D33353) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-11-29 |