| NPI | 1124715073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02008912A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151016213) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2026-06-24 |