| NPI | 1821552373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101270156) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-2452) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2024-11-20 |