| NPI | 1487235289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2025-00329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01093709A) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2025-07-14 |