| NPI | 1184935173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A126220) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-3710) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A126220) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2016-02-18 |