| NPI | 1831423235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 82483301205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA a114237) |
| 207P00000X Emergency Medicine (Licence: NV 14389) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: UT 8248330-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2021-10-29 |