| NPI | 1891790408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO R2D20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R2D20) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2019-06-10 |