| NPI | 1629399779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 56233) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD458287) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2017-09-22 |