| NPI | 1457708240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 30612) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01081131A) |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2026-08-05 |