| NPI | 1508216672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.153303) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01080713B) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2025-06-17 |