| NPI | 1548657364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 58137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 309548) |
| 207P00000X Emergency Medicine (Licence: KY 51950) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2020-08-25 |