| NPI | 1801325030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 008393) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA HS000288L) |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2020-08-07 |