| NPI | 1114912326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01060344) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-110410) | 
| Enumeration Date | 2005-09-14 | 
| Last Update Date | 2022-07-21 |