| NPI | 1649268871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00000047587) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01054612A) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2013-10-31 |