| NPI | 1588813257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 47627) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E6321) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2011-12-30 |