| NPI | 1700317856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 101008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61136579) |
| 207P00000X Emergency Medicine (Licence: IN 01081184A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2025-09-04 |