| NPI | 1619990116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G32244) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G32244) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA G32244) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-01-08 |