| NPI | 1114159514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 18231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 44845) |
| 207P00000X Emergency Medicine (Licence: IN 01088591A) | |
| 207P00000X Emergency Medicine (Licence: TX Q6325) | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2025-06-17 |