| NPI | 1962667659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N9606) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01067641A) |
| 207P00000X Emergency Medicine (Licence: VA 0101246874) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2011-06-27 |