| NPI | 1194348938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A22418) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT019879) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2024-08-23 |