| NPI | 1396935177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1735) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD 14667) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: HI MD 14667) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: AK 7251) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX Q1735) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2016-11-08 |