| NPI | 1144404526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A-2435-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: TN 2145) | |
| 207P00000X Emergency Medicine (Licence: WA op60257361) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2023-11-09 |