| NPI | 1306424866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1024280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0099565) |
| 207P00000X Emergency Medicine (Licence: CT 80286) | |
| 207P00000X Emergency Medicine (Licence: IN 01096326A) | |
| 207P00000X Emergency Medicine (Licence: IL 036174438) | |
| 207P00000X Emergency Medicine (Licence: PA MD483436) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-08-26 |