| NPI | 1336596964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C184128) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 57972) |
| 207P00000X Emergency Medicine (Licence: OH 35.133662) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2023-05-03 |