| NPI | 1801816061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: UT 6113266-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 61132661205) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO 6113266) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-09-30 |