| NPI | 1497707079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01069481A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 255972-1) |
| 207Q00000X Family Medicine (Licence: NY 255972-1) | |
| 207P00000X Emergency Medicine (Licence: VA 0101245736) | |
| 207Q00000X Family Medicine (Licence: IN 01069481A) | |
| 207Q00000X Family Medicine (Licence: PA MD053749L) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-10-06 |