| NPI | 1306263678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 53625) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000053625) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2022-11-09 |