| NPI | 1679534309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 41557) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2005-00517) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2016-08-19 |