| NPI | 1457585432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101251212) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: DE C7-0004254) | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2012-04-03 |