| NPI | 1457855090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 309801) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA11367200) |
| 207P00000X Emergency Medicine (Licence: FL ME145517) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-05-24 |