| NPI | 1730709627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 67662) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 30540) |
| 207P00000X Emergency Medicine (Licence: AL 43596) | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2025-04-25 |