| NPI | 1053379537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 51588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 057630) |
| 207P00000X Emergency Medicine (Licence: MA 74892) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2022-08-02 |