| NPI | 1255581773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A119483) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 32197) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R70205) | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2021-12-15 |