| NPI | 1457375347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 32946) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01084310A) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-12-03 |