| NPI | 1427076793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: ME MD12549) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD12549) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-02-14 |