| NPI | 1689315194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 33597301) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD487783) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-07-25 |