| NPI | 1770886483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A114959) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01087852A) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2022-07-06 |