| NPI | 1033593538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME135275) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 19837) |
| 207P00000X Emergency Medicine (Licence: MO 2018023743) | |
| 207P00000X Emergency Medicine (Licence: CA A153797) | |
| 207P00000X Emergency Medicine (Licence: TX R7581) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 32761-R) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 33300-R) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 32049-R) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2018-08-10 |