| NPI | 1417454323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 0068729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A187544) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: AZ 79291) | |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2026-06-01 |