| NPI | 1831321553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD0000006679) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: TN MD0000006679) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2009-08-13 |