| NPI | 1700572419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 35431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-5031) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2025-06-29 |