| NPI | 1285210948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-159405) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 330283) |
| 207P00000X Emergency Medicine (Licence: IN 01093777A) | |
| 207P00000X Emergency Medicine (Licence: AZ 76453) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-03-12 |