| NPI | 1689298192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-1813) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151014571) |
| 207P00000X Emergency Medicine (Licence: MI 5101026854) | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2023-06-29 |