| NPI | 1528068475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 0159032) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301510325) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2025-05-14 |