| NPI | 1124394820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01082820A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2019046391) |
| 207P00000X Emergency Medicine (Licence: PA MD462954) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA09749100) | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2020-10-14 |