| NPI | 1558685107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: PA MD480051) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T5139) |
| 207P00000X Emergency Medicine (Licence: VA 0101255248) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX T5139) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2023-05-04 |