| NPI | 1184179178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01096416A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 316821) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2025-07-22 |