| NPI | 1275116733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO220368) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101027129) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-10-28 |