| NPI | 1386825941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.29868) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 20786) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2015-06-26 |