| NPI | 1063463552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301074228) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01081482A) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-11-03 |