| NPI | 1649487430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: ID M-10687) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-10687) |
| 207P00000X Emergency Medicine (Licence: IA R-7842) | |
| 207P00000X Emergency Medicine (Licence: OR MD183860) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-03-31 |