| NPI | 1366482648 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01079736A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R0916) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-03-07 |