| NPI | 1700161700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 2823) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS14228) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2025-07-11 |