| NPI | 1740741966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME152557) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.150711) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-05-08 |