| NPI | 1780616458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02006450A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 50401) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-04-14 |