| NPI | 1326676628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 69698) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 330911) |
| 207P00000X Emergency Medicine (Licence: SC 89645) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-04-03 |