| NPI | 1801180237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 258521) |
| Additional Taxonomies | 2083C0008X Preventive Medicine Clinical Informatics (Licence: MA 258521) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 249014) | |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2022-06-29 |