| NPI | 1992818132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00048712) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME83198) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WA MD00078712) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2008-05-14 |