| NPI | 1699016063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02004758A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65873-21) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2019-12-12 |