| NPI | 1669826285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-45699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01084070A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 910442318) | |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2022-02-23 |