| NPI | 1932259694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY R1260) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01069318A) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2025-04-09 |