| NPI | 1609859487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102202457) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02002775A) |
| 207P00000X Emergency Medicine (Licence: PA OS014294) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2010-06-05 |