| NPI | 1285044289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1016150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10273300) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2023-07-17 |