| NPI | 1275585556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 54906) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01051017A) |
| 207Q00000X Family Medicine (Licence: IN 01051017A) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-07-31 |