| NPI | 1063506830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME164638) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01041413) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-01-26 |