| NPI | 1033378591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 25419) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NE 25419) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2025-09-26 |