| NPI | 1497229355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 23926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME174078) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2026-05-27 |