| NPI | 1295266773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME145820) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN24747) |
| 207P00000X Emergency Medicine (Licence: FL TRN24747) | |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2020-07-27 |