| NPI | 1245737188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T0728) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 1245737188) |
| 207P00000X Emergency Medicine (Licence: CA A179942) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA T68740844) | |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2023-02-14 |