| NPI | 1669433512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01068910A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35080854S) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2021-09-16 |