| NPI | 1164041661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD478852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT221739) |
| 207P00000X Emergency Medicine (Licence: NH 24193) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT221739) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-06-11 |