| NPI | 1629335534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2015016613) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA D.O. 0000343) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2026-04-14 |