| NPI | 1417071671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 46212) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 43008) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2015-04-29 |