| NPI | 1457762437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 510102117) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02008596A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101021117) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2025-10-09 |