| NPI | 1508061474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 047403) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 250087-1) |
| 207P00000X Emergency Medicine (Licence: CA A106810) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2021-12-15 |