| NPI | 1588261556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4351047546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX V0411) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2024-06-14 |