| NPI | 1134320526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102202183) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017420) |
| 207P00000X Emergency Medicine (Licence: NC 188876) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2013-06-10 |