| NPI | 1730408279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q5512) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01069957A) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2025-01-31 |