| NPI | 1376553339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 36271) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01069190A) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-04-13 |