| NPI | 1316365281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 61900) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MN 61900) |
| 207P00000X Emergency Medicine (Licence: MO 2016030784) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2020-10-09 |