| NPI | 1790988582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 50908) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 20868) |
| 207P00000X Emergency Medicine (Licence: GA 71607) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2022-06-23 |