| NPI | 1346665684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 4483) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.005460) |
| 207P00000X Emergency Medicine (Licence: IN 02005293A) | |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2023-10-20 |