| NPI | 1477521391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: PA MD067249L) |
| Additional Taxonomies | 2086S0129X (Licence: PA BS4217407) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: PA MD067249L) | |
| 208600000X Surgery (Licence: PA MD-067249L) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2026-05-12 |