| NPI | 1215344064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 60611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 50294) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2022-03-29 |