| NPI | 1962883603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02005646A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 04805) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2021-07-26 |