| NPI | 1326244617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 102204543) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID Pending) |
| 207P00000X Emergency Medicine (Licence: MT 113027) | |
| 207P00000X Emergency Medicine (Licence: UT 12898487-1204) | |
| 207P00000X Emergency Medicine (Licence: TX N0200) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2022-10-03 |