| NPI | 1811375835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01099277A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61329987) |
| 207P00000X Emergency Medicine (Licence: KY C2437) | |
| 207P00000X Emergency Medicine (Licence: TX BP10053763) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2026-08-17 |