| NPI | 1316946304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MO R7N50) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO MDR7N50) |
| 207P00000X Emergency Medicine (Licence: MO MDR7N50) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: KS 0431677) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2021-09-03 |