| NPI | 1508210188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD489606C) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1025069) |
| 207P00000X Emergency Medicine (Licence: IN 01087883A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: CT 80609) | |
| 207P00000X Emergency Medicine (Licence: IL 036152760) | |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2025-10-09 |