| NPI | 1659573889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M10210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01062424A) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2022-07-21 |