| NPI | 1982712543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-26382) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: KS 0426382) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-07-03 |