| NPI | 1275037624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 86823) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: VA 0102207284) | |
| 207P00000X Emergency Medicine (Licence: FL OS20681) | |
| 207P00000X Emergency Medicine (Licence: CA 19393) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-11-14 |