| NPI | 1538554704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S0975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301107469) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2020-11-13 |