| NPI | 1053502658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301044974) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01053409a) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2008-02-13 |