| NPI | 1356877526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U9645) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 25MB10645700) |
| 207Q00000X Family Medicine (Licence: NJ 25MB10645700) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-12-02 |