| NPI | 1710923990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 62637) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0058847) |
| 207P00000X Emergency Medicine (Licence: KY 48670) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2021-02-10 |