| NPI | 1659323061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02002226A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65110) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 015555) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-03-25 |