| NPI | 1811350705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.148100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301505821) |
| 207P00000X Emergency Medicine (Licence: IN 01083406A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-07-27 |