| NPI | 1922081090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 40395) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01082982A) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-06-01 |