| NPI | 1437681707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS20621) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB11085500) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-06-18 |