| NPI | 1457745366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 54938) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD046974) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX S5683) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2021-07-27 |