| NPI | 1902014731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A78703) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01087373A) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-08-23 |