| NPI | 1619403292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01097203A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A171277) |
| 207P00000X Emergency Medicine (Licence: NY 305257) | |
| 207P00000X Emergency Medicine (Licence: OH 35C.002960) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA10743300) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2025-11-05 |