| NPI | 1730642695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 292515) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01089268A) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2023-07-17 |