| NPI | 1780262949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 335804) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: MD D0104629) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 335804) | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2026-04-27 |