| NPI | 1669866141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NH 18692) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63644) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2018-07-10 |