| NPI | 1831572254 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01080188A) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301108207) | 
| Enumeration Date | 2015-07-02 | 
| Last Update Date | 2025-10-09 |