| NPI | 1508552001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME178670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A205819) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2026-05-23 |