| NPI | 1629424346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 57249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 0000057249) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2023-02-07 |