| NPI | 1669993960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 55195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01100322A) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2026-06-05 |