| NPI | 1275727281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 51576) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101246169) |
| Enumeration Date | 2007-09-03 |
| Last Update Date | 2024-04-10 |