| NPI | 1396235461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 17607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND PT17607) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2021-08-27 |