| NPI | 1699099325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-16329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60455921) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2025-03-17 |