| NPI | 1548498074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID OC-0164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02003857A) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-12-31 |