| NPI | 1508283482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME132030) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 301387) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-08-08 |