| NPI | 1699173351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 109178) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01078043A) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2022-07-11 |