| NPI | 1700016540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD196474) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.130981) |
| 207P00000X Emergency Medicine (Licence: TN 52667) | |
| 207P00000X Emergency Medicine (Licence: TX P1183) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2022-04-18 |