| NPI | 1942798053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-48222) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01082622A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019751A) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2021-11-26 |