| NPI | 1447270863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0425141) |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: KS 0425141) |
| 207P00000X Emergency Medicine (Licence: MO R2K05) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-06-10 |