| NPI | 1205455037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V3317) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01091096A) |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2025-05-22 |