| NPI | 1013202019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD19739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 23528) |
| 207P00000X Emergency Medicine (Licence: LA MD.206893) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2023-05-09 |