| NPI | 1033607395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 318906) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 13-3971298) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-09-16 |