| NPI | 1891135240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS T-2670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 23532) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2016-11-30 |