| NPI | 1669978235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T8916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 63219) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX T8916) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-11-09 |