| NPI | 1972547172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 24216) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-11866) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-07-07 |