| NPI | 1457707051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CT 74914) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA A161616) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MD476594) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2023-08-04 |