| NPI | 1164465209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2015-00451) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01057821A) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-11-18 |