| NPI | 1730354697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD46252) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301090748) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2022-03-25 |