| NPI | 1356878292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: FL OS17529) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 303251) |
| 207P00000X Emergency Medicine (Licence: FL OS17529) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-04-22 |