| NPI | 1548604283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0014088) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VT 042.0014088) |
| 207P00000X Emergency Medicine (Licence: NH 17578) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NH 17578) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2018-11-12 |