| NPI | 1407377385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO197982) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02005861A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.071139) | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2021-03-25 |