| NPI | 1639256183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101250600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 40718) |
| 207P00000X Emergency Medicine (Licence: GA 059446) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-01-31 |