| NPI | 1790434090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 169083) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2024-10-22 |