| NPI | 1427462100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2020-0576) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R0442) |
| 207P00000X Emergency Medicine (Licence: AK 141172) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-08-18 |