| NPI | 1760685358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD-18344) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2007015089) |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2016-05-19 |