| NPI | 1235254228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A10169) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV SL0472) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2023-03-07 |