| NPI | 1427132778 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M5655)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01051145A)  | 
| Enumeration Date | 2006-10-24 | 
| Last Update Date | 2009-06-03 |