| NPI | 1134269038 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9900333) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01042793A) | 
| Enumeration Date | 2007-02-08 | 
| Last Update Date | 2022-07-13 |