| NPI | 1588830731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D71084) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092814) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2021-12-14 |