| NPI | 1679598361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01071930A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 29148) |
| 207P00000X Emergency Medicine (Licence: PA MD073595L) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-04-13 |