| NPI | 1043466980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.204890) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01072210A) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2025-04-30 |