| NPI | 1841495074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 63688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 11013891A) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2015-03-18 |