| NPI | 1124302799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01075089A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301099474) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2015-11-11 |