| NPI | 1730684606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61156257) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD24026) |
| 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-94961) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2023-08-16 |