| NPI | 1134660467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S8035) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL F65593291031) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-08-09 |