| NPI | 1437158391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MO 2000161122) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO D0161122) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO DO161122) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2022-07-21 |