| NPI | 1124512058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101024601) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02006550B) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2024-07-17 |