| NPI | 1669793147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 73394) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: WI 73394) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2025-04-08 |