| NPI | 1679599518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2001022240) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01046504A) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2009-01-19 |