| NPI | 1497735393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: MN 36049) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MN 36049) |
| 207P00000X Emergency Medicine (Licence: MN 36049) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-03-14 |