| NPI | 1376586834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-101128) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 44671-020) |
| 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: WI 44671-20) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2023-06-30 |