| NPI | 1689609240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 5768480-1205) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: UT 5768480-1205) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2026-05-06 |