| NPI | 1801807219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 18148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-17427) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2025-11-04 |