| NPI | 1043212038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 21742) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 18490) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-01-13 |