| NPI | 1427540566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 4298) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY TP989) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-08-25 |