| NPI | 1245692409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 282309) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0093596) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-08-06 |