| NPI | 1578023354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME155269) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN28358) |
| 207P00000X Emergency Medicine (Licence: FL TRN28358) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2022-06-24 |