| NPI | 1386807311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME128253) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 18221) |
| 207P00000X Emergency Medicine (Licence: TX P8329) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2022-02-15 |