| NPI | 1609866391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L8040) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01067806A) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2015-10-21 |