| NPI | 1033472592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 52932) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301100815) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2015-10-06 |