| NPI | 1831533306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102204437) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 3004) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2022-01-19 |