| NPI | 1609225283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO192464) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101022549) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101022549) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2024-01-31 |