| NPI | 1427218221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 47041) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 11016969A) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2021-05-28 |