| NPI | 1235440132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD165010) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-12295) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R72066) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2022-07-19 |