| NPI | 1477040392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042-0016240) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 318447) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-09-02 |