| NPI | 1740216688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM 2006-0008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD-27634) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2010-01-04 |