| NPI | 1285659607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 2660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL os6352) |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL os6352) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-01-03 |