| NPI | 1902334568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 83102) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IN 02005448A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019228A) | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2021-03-15 |