| NPI | 1144614603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 3425) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 82197-21) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: MS T-2975) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2026-06-30 |