| NPI | 1164600904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD20624) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01065537A) |
| 207P00000X Emergency Medicine (Licence: TN 51054) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2015-06-25 |