| NPI | 1073045597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 312696) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.13911) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2022-02-08 |