| NPI | 1396131843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 19242) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 57681) |
| 207P00000X Emergency Medicine (Licence: NH LT3989) | |
| 207P00000X Emergency Medicine (Licence: VA 0101263171) | |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2019-03-06 |