| NPI | 1154993129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP10092239) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 41114177) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-07-10 |
| Last Update Date | 2025-04-29 |