| NPI | 1730507575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036156862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 84999) |
| 207R00000X Internal Medicine (Licence: GA 84999) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM AB7003469) | |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2022-07-08 |