| NPI | 1437563715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 67195) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101021339) |
| 207P00000X Emergency Medicine (Licence: MI 5101021339) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2020-10-08 |