| NPI | 1679065338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1015467) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: VA 0102206640) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-05-31 |