| NPI | 1790027043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301103098) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01078530A) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2025-10-02 |