| NPI | 1396955563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R9363) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01064576A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 01064576A) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-08-26 |