NPI | 1962643882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: PA OS014383) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS014383) |
Enumeration Date | 2009-03-24 |
Last Update Date | 2016-06-04 |