| NPI | 1336679430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 117034591205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01080994A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019354A) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2020-08-17 |