| NPI | 1376032755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 287384) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A24587) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2026-03-03 |