| NPI | 1366978439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021042772) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 202109600) |
| 208600000X Surgery (Licence: VA 0116030424) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2022-01-06 |