| NPI | 1376172700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 33846) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD28049) |
| 207P00000X Emergency Medicine (Licence: NY 328550) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-07-10 |