| NPI | 1306853577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD042171) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 56949) |
| 207P00000X Emergency Medicine (Licence: TN 42171) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-11-18 |