| NPI | 1801245675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 28929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2019-01568) |
| 207P00000X Emergency Medicine (Licence: GA 83357) | |
| 207P00000X Emergency Medicine (Licence: VA 0101266443) | |
| 207P00000X Emergency Medicine (Licence: OH 35.138120) | |
| 207P00000X Emergency Medicine (Licence: TX R4457) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-12 |
| Last Update Date | 2020-06-15 |