| NPI | 1285925537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD21872) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2014-0219) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2019-07-01 |