| NPI | 1912056300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 44332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 24382) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-05-18 |