| NPI | 1528420890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 14203861-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 19149) |
| 207P00000X Emergency Medicine (Licence: IN 01079830A) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2025-06-05 |