| NPI | 1366077471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A195909) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351048051) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2024-06-28 |