| NPI | 1245721653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R76900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-22269) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2025-11-13 |