| NPI | 1144544602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS10925) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL OS-10925) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2014-10-15 |