| NPI | 1114554383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 329777) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01093747A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-07-17 |