| NPI | 1538143524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.47305) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01059311A) |
| 207P00000X Emergency Medicine (Licence: KY 39854) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2024-02-02 |