| NPI | 1568212652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.54554) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL L.6305R) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2026-07-22 |