| NPI | 1154663821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 64643) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0082121) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD D0082121) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-06-01 |