| NPI | 1306283171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-01882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q8631) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2024-03-01 |