| NPI | 1245551001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A125105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 54320) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2020-10-19 |