| NPI | 1750581252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MI 4301092032) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092032) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2012-05-29 |