| NPI | 1861463903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 60072215) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01060155a) |
| 207P00000X Emergency Medicine (Licence: TN 41352) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2012-03-01 |