| NPI | 1689968984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT014277) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02004412A) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2024-06-07 |