| NPI | 1841239647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 2028) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 02777) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-08-28 |