| NPI | 1215428305 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01083825A) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019893A) | 
| Enumeration Date | 2018-05-23 | 
| Last Update Date | 2022-09-09 |