| NPI | 1588675706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 40162) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01057803A) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-08-20 |