| NPI | 1174822332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 47195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.33281) |
| 207P00000X Emergency Medicine (Licence: IN 01072840A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 47195) | |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2022-02-17 |