| NPI | 1750564217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01090494A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 47146) |
| 207P00000X Emergency Medicine (Licence: NC 2008-01729) | |
| 207P00000X Emergency Medicine (Licence: TN 46186) | |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2023-12-29 |