| NPI | 1699208447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0443239) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2020008152) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2020-11-19 |