| NPI | 1427582881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 25534) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 157824) |
| 208D00000X General Practice (Licence: VA 0102205459) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2024-07-16 |