| NPI | 1275034225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID 9071990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: Student) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2026-02-03 |