| NPI | 1053540617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 21713) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-2223) |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2023-02-01 |