| NPI | 1508358128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01083658A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.141598) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019922A) | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2021-05-18 |