| NPI | 1447289616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 19589) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: KY 19589) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2016-02-17 |