| NPI | 1891987905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |