| NPI | 1316507320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1022355) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11020743A) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-06-23 |