| NPI | 1780774208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00015177) |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: WA MD00015177) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-10-30 |