| NPI | 1679718563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL os12408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: NJ 25mb0359000) | |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2014-05-16 |