| NPI | 1487217808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 321896) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A179447) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-07-31 |