| NPI | 1124405972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.145893) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA DO-05336) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2019-06-11 |