| NPI | 1902992019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 49465) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01052892) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-08-19 |