| NPI | 1447319975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: GA 080791) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MI 4301089165) |
| 207Q00000X Family Medicine (Licence: MI 4301089165) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2018-12-17 |