| NPI | 1083077333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2019039164) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2019039164) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2019039164) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2021-07-27 |