| NPI | 1467453258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 02310) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02006148A) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2021-06-02 |