| NPI | 1619385937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 50185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01085579A) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2021-06-02 |