| NPI | 1396475976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4351050119) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01094749A) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2025-08-13 |