| NPI | 1548670383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.138205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01092815A) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2025-09-08 |