| NPI | 1285129148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A17869) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 4489) |
| 207P00000X Emergency Medicine (Licence: PA OT018579) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2022-03-24 |