| NPI | 1497017693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2013027465) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO 2013027465) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2025-01-13 |