| NPI | 1023016607 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02001355) | 
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: IN 02001355) | 
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2024-08-07 |