| NPI | 1962513218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 29592) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA A90494) |
| 207P00000X Emergency Medicine (Licence: CA A90494) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-03-15 |