| NPI | 1316923311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IA 20448) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: IA 20448) |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: IA 20448) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2007-07-08 |