| NPI | 1619406816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01083514A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214001) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2020-04-14 |