| NPI | 1407880644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q5403) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: AR E-2431) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-01-13 |