| NPI | 1912249814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 54598) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 48393) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2016-06-28 |