| NPI | 1417243635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 38870) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 0722343) |
| 207P00000X Emergency Medicine (Licence: NC AP1180885-146) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2018-03-17 |