| NPI | 1356979249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 5469) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R5360) |
| 207Q00000X Family Medicine (Licence: AL DO.2790) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2024-04-04 |