| NPI | 1174133292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301511262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351047878) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2024-05-20 |