| NPI | 1639316797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-46598) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 266197) |
| 207P00000X Emergency Medicine (Licence: TX R0031) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2022-09-09 |