| NPI | 1437681434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CT 067505) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 302938) |
| 207P00000X Emergency Medicine (Licence: CT 067505) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-03-28 |