| NPI | 1699169698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-45379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66570-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2018-12-06 |