| NPI | 1568859874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-47407) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-47407) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2020-06-03 |