| NPI | 1639142151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2013021433) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01036901A) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2023-10-27 |