| NPI | 1558758268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101267667) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 58385) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2019-12-06 |