| NPI | 1881665966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036151467) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01089382A) |
| 207P00000X Emergency Medicine (Licence: VA 0101238619) | |
| 207P00000X Emergency Medicine (Licence: WV 29503) | |
| 208D00000X General Practice (Licence: IN 01089382A) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2025-07-22 |