| NPI | 1578057758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01087998A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301116001) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2022-08-10 |