| NPI | 1982691499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 19311) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01029113A) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2011-05-05 |