| NPI | 1316986821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD22317) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: OR MD22317) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-01-24 |