| NPI | 1649299207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 059739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME126139) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: VA 0101236808) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-02-09 |