| NPI | 1316406184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO.2919) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: FL OS17865) | |
| 207P00000X Emergency Medicine (Licence: GA 89798) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-06-03 |