| NPI | 1184185142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3283) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102206439) |
| 207P00000X Emergency Medicine (Licence: AZ 011820) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2026-08-25 |