| NPI | 1740265982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M8001) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01056550A) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-03-03 |