| NPI | 1740624691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 79610) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO2113) |
| 207P00000X Emergency Medicine (Licence: NY 283605) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2025-06-09 |