| NPI | 1134574601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-14682) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD192553) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ID MSM-0256) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2019-08-02 |