| NPI | 1053998443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM DO2024-0047) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 010747) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-07-12 |