| NPI | 1932359650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 42881) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01065813A) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2014-10-07 |