| NPI | 1235330861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA 60203700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301090009) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301090009) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2024-03-18 |