| NPI | 1063831097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 55987) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 24212) |
| 207P00000X Emergency Medicine (Licence: LA 207853) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2018-05-14 |