| NPI | 1578190740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02007476A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.016868) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-10-15 |