| NPI | 1861819740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 306693) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01081015A) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-08-09 |