| NPI | 1083000178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2017-0770) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2015-0373) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2024-10-10 |