| NPI | 1720195407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NY 255162) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A82212) |
| 207P00000X Emergency Medicine (Licence: NY 255162) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2010-05-11 |