| NPI | 1053870972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO.3215) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: NC 2022-00403) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-10-15 |