| NPI | 1457667537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 274175) |
| 207P00000X Emergency Medicine (Licence: CA 16825) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2022-10-13 |