| NPI | 1003015157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C174324) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N6229) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2022-01-05 |