| NPI | 1376574921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.025030) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: LA MD.025030) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-08-25 |