| NPI | 1841220696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: SC 10579) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 10579) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-08-30 |