| NPI | 1467422402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J6917) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX J6917) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX J6917) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2010-08-24 |