| NPI | 1376749820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01065850A)  | 
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX P9182)  | 
| Enumeration Date | 2007-06-22 | 
| Last Update Date | 2025-06-20 |