| NPI | 1073860441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 006363) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX P5597) |
| 207P00000X Emergency Medicine (Licence: TX P5597) | |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2015-06-11 |