| NPI | 1326677584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD210011394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD479504) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-08-23 |