| NPI | 1609967983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: MD D39370) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MD D39370) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-13 |