| NPI | 1962503458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 39766) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01060927A) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2014-06-05 |