| NPI | 1578192167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12265300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: FL 25MB12265300) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2025-01-03 |