| NPI | 1730321969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0438276) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-22379) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2025-12-02 |