| NPI | 1346350683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 103748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2008-01645) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 103748) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-04-02 |