| NPI | 1508221474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ZZ BES5456lk) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ZZ 98912014BES) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2024-02-24 |