| NPI | 1629016472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 41114-020) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WI 41114-20) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2014-08-06 |