| NPI | 1700091477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TN MD0000046602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 27925) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NC 2009-00680) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2010-10-20 |