| NPI | 1699840561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01059800A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.151753) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2025-08-14 |