| NPI | 1619973641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: FL ME49872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0049872) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2020-09-03 |