| NPI | 1265602999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 52714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 80913) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2015-06-04 |