| NPI | 1326046962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME41908) |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: FL ME41908) |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: FL ME41908) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2018-04-03 |