| NPI | 1578856233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2018-0016) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM RS2017-0741) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2019-07-25 |