| NPI | 1861418709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01056697A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 19841) |
| 207P00000X Emergency Medicine (Licence: OK 20694) | |
| 207P00000X Emergency Medicine (Licence: IL 036-112914) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-03-25 |