| NPI | 1861629925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2012-00981) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NC 2012-00981) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2012-11-29 |