| NPI | 1508449448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD28862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U5235) |
| 207Q00000X Family Medicine (Licence: TX U5235) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2024-12-19 |