| NPI | 1457321820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 851) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN DO1265) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2018-10-19 |