| NPI | 1235542804 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 90889) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01077549A) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2025-02-12 |