| NPI | 1376837625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 72857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 278837-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2022-11-03 |