| NPI | 1487271219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD215229) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME158009) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: FL 31675) | |
| Enumeration Date | 2020-06-27 |
| Last Update Date | 2023-08-21 |