| NPI | 1316576606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20934) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020337) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT020337) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2023-07-27 |