| NPI | 1386605095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 42611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-18322) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-06-02 |