| NPI | 1073074050 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 189642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 62694) |
| 207P00000X Emergency Medicine (Licence: CA A194738) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2024-05-07 |