| NPI | 1750727681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD044320) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: CA A133466) | |
| 207P00000X Emergency Medicine (Licence: MD D0081654) | |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2016-07-28 |