| NPI | 1326353913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 294811) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI DO00875) |
| 207P00000X Emergency Medicine (Licence: NY 280921) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2023-07-17 |