| NPI | 1417184391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 51358) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11015046A) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2012-06-19 |