| NPI | 1578882171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 2742) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS015850) |
| 207P00000X Emergency Medicine (Licence: TN Do0000002742) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2015-05-19 |