| NPI | 1316357270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T6390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-9479) |
| 207P00000X Emergency Medicine (Licence: AL 38182) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2023-06-09 |