| NPI | 1346441938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 330318) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301089801) |
| 207P00000X Emergency Medicine (Licence: KY C1702) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301089801) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2024-01-04 |