| NPI | 1740624212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 006807) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02005068A) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2023-09-25 |