| NPI | 1689884439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 52124) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: AR E-5766) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-03-31 |