| NPI | 1316344179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A144988) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 61902) |
| 207P00000X Emergency Medicine (Licence: TX R3793) | |
| 207P00000X Emergency Medicine (Licence: FL 130052) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2023-10-31 |