| NPI | 1649733759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY TP166) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01093438A) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2024-06-14 |