| NPI | 1265845507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101264765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-2313) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2022-08-31 |