| NPI | 1538572847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.41416) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105567) |
| 207P00000X Emergency Medicine (Licence: NY 2918831) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301105567) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-03-03 |