| NPI | 1588709414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 261959) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0069312) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2019-05-17 |