| NPI | 1770907065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101276656) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0090740) |
| 207P00000X Emergency Medicine (Licence: MA 271639) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2023-05-09 |