| NPI | 1699161703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 83290) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2018-00162) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2023-03-08 |