| NPI | 1043825847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL TRN40084) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK N083587702) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2024-06-20 |