| NPI | 1366019523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301510225) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351048517APP21) |
| 207P00000X Emergency Medicine (Licence: IN 01092571A) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-04-24 |