| NPI | 1669122909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 76574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1022273) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2026-07-17 |