| NPI | 1073299731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 015247) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 15247) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-12-02 |