| NPI | 1639376973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301090237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01068092A) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-03-09 |