| NPI | 1477088045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 1477088045) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 60980) |
| 207P00000X Emergency Medicine (Licence: GA 99917) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2024-05-15 |