| NPI | 1336553957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP60807201) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 1397) |
| 207P00000X Emergency Medicine (Licence: TX R5042) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OK 7919) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2025-01-18 |