| NPI | 1366616864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: IL 036072026) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 67178) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: WI 67178) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2022-02-08 |