| NPI | 1225340680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA a118552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD14282) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2019-12-03 |