| NPI | 1386077279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME154049) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A133171) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2023-01-18 |