| NPI | 1447415690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD-17130) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT192589) |
| 207P00000X Emergency Medicine (Licence: UT 8391707-1205) | |
| 207P00000X Emergency Medicine (Licence: ID M-11357) | |
| Enumeration Date | 2008-07-26 |
| Last Update Date | 2016-01-22 |