| NPI | 1073834511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2014-0488) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2011026844) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2023-09-22 |