| NPI | 1821344805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD.41630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 196705) |
| 207P00000X Emergency Medicine (Licence: GA 075319) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2021-07-01 |