| NPI | 1033950449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R4222) |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2025-08-26 |