| NPI | 1588083356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R3469) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 28887) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2024-03-25 |