| NPI | 1982687059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 28304) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2000148568) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2018-10-17 |