| NPI | 1558628164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 86642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0083660) |
| 207P00000X Emergency Medicine (Licence: VA 0101258039) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2022-08-02 |