| NPI | 1710419387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 24331) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 1710419387) |
| 207P00000X Emergency Medicine (Licence: IN 01086792A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2024-06-06 |