| NPI | 1356371272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 85256) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NY 259734) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: AR 1432) | |
| 207Q00000X Family Medicine (Licence: GA 85256) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-07-24 |