| NPI | 1790739936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301070399) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01092757A) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-07-15 |