| 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 |