| NPI | 1831293141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME68021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME68021) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2018-11-01 |