| NPI | 1740279538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01030792A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 33746) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2010-11-04 |