| NPI | 1245690973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS16829) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT017452) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2020-06-23 |