| NPI | 1043952369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A190125) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 27068) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2025-05-12 |