| NPI | 1447489570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-00766) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP01824) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2014-07-09 |