| NPI | 1346588811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 175659) |
| Additional Taxonomies | 174H00000X Health Educator |
| 207P00000X Emergency Medicine (Licence: NY 310534) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2023-10-27 |