| NPI | 1942591078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0075765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD0000052655) |
| Enumeration Date | 2011-04-23 |
| Last Update Date | 2021-08-27 |