| NPI | 1609194067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 49230) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101253884) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2016-08-25 |