| NPI | 1891981536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M7922) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX M7922) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2025-03-14 |