| NPI | 1821383944 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101261779)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01076107a)  | 
| 207P00000X Emergency Medicine (Licence: KY 47305)  | |
| Enumeration Date | 2011-06-16 | 
| Last Update Date | 2021-03-12 |