| NPI | 1841684073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-10048) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S0946) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2023-12-22 |