| NPI | 1376838375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD183370) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-12426) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2017-09-07 |