| NPI | 1427552496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 64132) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN26837) |
| 207P00000X Emergency Medicine (Licence: OH 35.144710) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN26837) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2022-05-24 |