| NPI | 1417318361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 008645) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 3749) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2022-07-08 |