| NPI | 1023308418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036140519) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301104552) |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: MI 4301104552) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301104552) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2018-11-02 |