| NPI | 1821593641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 54157) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01085205A) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2023-10-26 |