| NPI | 1912926445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NE 21088) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: NE 21088) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-09-02 |