| NPI | 1346877131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO3526) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 25337) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 64328) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-06-19 |